Form Orthotics & Prosthetics, Pllc

Prosthetic & Orthotic Supplier



 4921 E State St Lowr Level, Rockford
    Illinois, 61108-2275

 402-212-7878    Maps & Directions
Form Orthotics & Prosthetics, Pllc is a Prosthetic & Orthotic Supplier in Rockford, Illinois. It is situated at 4921 E State St Lowr Level, Rockford and its contact number is 402-212-7878. The authorized person of Form Orthotics & Prosthetics, Pllc is Micah Alford who is Founder of the store and his/her contact number is 402-212-7878.
Form Orthotics & Prosthetics, Pllc is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
Complete Profile:
Form Orthotics & Prosthetics, Pllc Center speciality, address, contact phone number and fax are as below. Patients can directly walkin to the Prosthetic/Orthotic center or can call on the below given phone number for appointment.
Specialization: Prosthetic & Orthotic Supplier
Address:4921 E State St Lowr Level, Rockford,
Illinois, 61108-2275
Phone:402-212-7878
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this store are as below. Person's position and contact details are also mentioned below.
Name: Micah Alford
Position: Founder
Contact Number: 402-212-7878
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details for Form Orthotics & Prosthetics, Pllc center are as mentioned below.
NPI Number: 1740113422
NPI Enumeration Date: 04 Jun, 2026
NPI Last Update On: 04 Jun, 2026
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Form Orthotics & Prosthetics, Pllc are as mentioned below.
SpecializationLicense NumberStateStatus
Prosthetic/orthotic Supplier Primary
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address: Form Orthotics & Prosthetics, Pllc
4921 E State St Lowr Level,
Rockford, Illinois
Zip: 61108-2275
Phone Number: --
Patients can reach Form Orthotics & Prosthetics, Pllc at 4921 E State St Lowr Level, Rockford, Illinois or can call to book an appointment on 402-212-7878.
Comments/ Reviews:
Patients can read all the reviews posted for Form Orthotics & Prosthetics, Pllc below. You may also share your own experience like the quality of treatment, behavior, and overall care provided by Form Orthotics & Prosthetics, Pllc. It will help others make informed decisions.

** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 June, 2026.